title: Prevalence of Clostridium difficile colonization among healthcare workers.
abstract: BACKGROUND
  Clostridium difficile infection (CDI) has increased to epidemic proportions in recent years. The carriage of C. difficile among healthy adults and hospital inpatients has been established. We sought to determine whether C. difficile colonization exists among healthcare workers (HCWs) in our setting.
  
  
  METHODS
  A point prevalence study of stool colonization with C. difficile among doctors, nurses and allied health staff at a large regional teaching hospital in Geelong, Victoria. All participants completed a short questionnaire and all stool specimens were tested by Techlab® C.diff Quik Check enzyme immunoassay followed by enrichment culture.
  
  
  RESULTS
  Among 128 healthcare workers, 77% were female, of mean age 43 years, and the majority were nursing staff (73%). Nineteen HCWs (15%) reported diarrhoea, and 12 (9%) had taken antibiotics in the previous six weeks. Over 40% of participants reported having contact with a patient with known or suspected CDI in the 6 weeks before the stool was collected. C. difficile was not isolated from the stool of any participants.
  
  
  CONCLUSIONS
  Although HCWs are at risk of asymptomatic carriage and could act as a reservoir for transmission in the hospital environment, with the use of a screening test and culture we were unable to identify C. difficile in the stool of our participants in a non-outbreak setting. This may reflect potential colonization resistance of the gut microbiota, or the success of infection prevention strategies at our institution.
authors.affiliation: Department of Medicine and Infectious Diseases, Barwon Health, Geelong, Victoria, Australia. Deborahf@barwonhealth.org.au.
authors.forename: N Deborah
authors.initials: ND
authors.lastname: Friedman
authors.forename: James
authors.initials: J
authors.lastname: Pollard
authors.forename: Douglas
authors.initials: D
authors.lastname: Stupart
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Knight
authors.forename: Masoomeh
authors.initials: M
authors.lastname: Khajehnoori
authors.forename: Elise K
authors.initials: EK
authors.lastname: Davey
authors.forename: Louise
authors.initials: L
authors.lastname: Parry
authors.forename: Thomas V
authors.initials: TV
authors.lastname: Riley
mesh_terms: D000328:Adult; D002353:Carrier State / Q000382:microbiology; D016360:Clostridioides difficile / Q000235:genetics / Q000254:growth & development / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000453:epidemiology* / Q000382:microbiology; D005243:Feces; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult